Lower Abdominal Discomfort: When to Seek Medical Help

Discomfort in the lower abdomen?

Hello, doctor.
I often feel discomfort and slight bloating in my lower abdomen, sometimes accompanied by lower back pain (not unilateral), and occasionally it even causes leg discomfort.
A gynecologist once mentioned that it could be due to uterine inflammation, and I have received treatment for it.
However, the symptoms appear intermittently.
Last year, I had polyps removed from my colon.
Should I see a rehabilitation specialist (for the mild leg discomfort and numbness), return to the gynecology department, or undergo another painful colonoscopy?

candy, 30~39 year old female. Ask Date: 2005/05/13

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Hello, abdominal bloating may be due to abnormal intestinal motility or gynecological issues (such as pelvic congestion, ovarian cysts, or uterine fibroids).
It is advisable to consult a gynecologist for an examination.
Lower back pain and leg numbness may indicate a skeletal issue, so seeing an orthopedic specialist would be appropriate.
If a thorough colonoscopy was performed last year (including examination of the cecum), there should be no need for another this year.
Your symptoms could also be related to psychosomatic disorders or autonomic nervous system dysregulation.
I recommend relaxing, engaging in moderate exercise, eating smaller, more frequent meals, and reducing the intake of greasy foods.
Sincerely, Dr.
Yuan Hong-Dao, Internal Medicine.

Reply Date: 2005/05/13

More Info

When it comes to understanding lower abdominal discomfort, especially in the context of your symptoms, it is essential to approach the situation with a comprehensive understanding of potential underlying causes and the appropriate medical specialists to consult. Given your history of gynecological issues, previous colon polyps, and current symptoms of lower abdominal pain, bloating, and associated discomfort in the lower back and legs, it is crucial to consider a multidisciplinary approach.

Understanding Your Symptoms
Lower abdominal discomfort can arise from various sources, including gastrointestinal, gynecological, and musculoskeletal issues. Since you have a history of uterine inflammation and colon polyps, it is vital to keep these factors in mind.
1. Gynecological Causes: Conditions such as endometriosis, pelvic inflammatory disease, or ovarian cysts can lead to chronic pelvic pain. If a gynecologist previously diagnosed you with uterine inflammation, it may be worth revisiting this specialist to rule out any recurrent or new gynecological issues.

2. Gastrointestinal Causes: Given your history of colon polyps, there is a possibility that gastrointestinal issues could be contributing to your symptoms. While the removal of polyps is a positive step, it does not eliminate the risk of new growths or other gastrointestinal conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). A gastroenterologist can provide further evaluation, including the necessity of a colonoscopy, especially if your symptoms persist or worsen.

3. Musculoskeletal Causes: The discomfort in your lower back and legs could be related to musculoskeletal issues, such as muscle strain or nerve compression. Physical therapy or rehabilitation specialists can help assess whether your symptoms are related to muscle imbalances or other physical factors.

When to Seek Medical Help
Given your symptoms and medical history, here are some guidelines on when to seek further medical help:
- Persistent Symptoms: If your lower abdominal discomfort continues or worsens, it is essential to consult a healthcare provider. Persistent symptoms can indicate an underlying condition that requires treatment.

- New Symptoms: If you experience new symptoms such as significant changes in bowel habits, unexplained weight loss, or severe pain, you should seek medical attention promptly.

- Follow-Up on Previous Conditions: Since you have a history of gynecological and gastrointestinal issues, regular follow-ups with your gynecologist and gastroenterologist are advisable. They can monitor for any changes or complications related to your previous conditions.

Recommendations
1. Consult a Gynecologist: Given your history of uterine inflammation, it would be prudent to revisit a gynecologist to rule out any gynecological causes for your symptoms. They may recommend imaging studies or further diagnostic tests to assess your reproductive organs.

2. Consult a Gastroenterologist: If your symptoms are more gastrointestinal in nature, a gastroenterologist can evaluate your digestive health. They may suggest a colonoscopy or other imaging studies to ensure there are no new polyps or other gastrointestinal issues.

3. Consider Physical Therapy: If musculoskeletal issues are suspected, a physical therapist can help assess your posture, movement patterns, and any contributing factors to your discomfort. They can provide exercises and strategies to alleviate pain and improve function.

4. Monitor Symptoms: Keep a symptom diary to track when your discomfort occurs, its intensity, and any associated factors (like diet or activity). This information can be valuable for your healthcare providers in diagnosing and treating your condition.

In conclusion, understanding the source of your lower abdominal discomfort requires a thorough evaluation by the appropriate specialists. Given your medical history, a coordinated approach involving gynecological and gastrointestinal assessments, along with consideration of musculoskeletal factors, will provide the best chance of identifying the underlying cause and developing an effective treatment plan.

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